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Cardiorresonancia magnética con secuencia 4D Flow antes y tras la ablación de venas pulmonares.

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Title: Cardiorresonancia magnética con secuencia 4D Flow antes y tras la ablación de venas pulmonares.
Alternate Title: Cardio-magnetic resonance with 4D Flow sequence before and after pulmonary vein ablation.
Authors: Álvarez-Vázquez, Ana1,2 anaalvarezvazquez@gmail.com, Sánchez-Martín, José T.1, Urmeneta-Ulloa, Javier1,2,3, Andreu-Vázquez, Cristina4, Pizarro-Sánchez, Gonzalo2,5, Martínez de Vega-Fernández, Vicente1,2
Source: Revista Argentina de Radiología. 2025, Vol. 89 Issue 4, p193-202. 10p.
Abstract (English): Introduction: Pulmonary vein ablation is an effective treatment for atrial fibrillation, although it may be associated with complications such as pulmonary vein stenosis, which is usually diagnosed with computed tomography (CT) or cardio-magnetic resonance imaging (CMR). The 4D Flow sequence in CMR could provide additional information on morphology and flow, before and after ablation, complementing the usual assessment. Objective: To assess the usefulness of CMR with 4D Flow sequence for the assessment of pulmonary veins (PV) in the context of radiofrequency ablation. Although ablation is a technique with a low percentage of complications, these must be diagnosed early through imaging tests, with CT and magnetic resonance (MRI) being the most used. The 4D Flow sequence that evaluates intravascular flow has not been studied in this context. Method: 16 patients underwent CMR and PV ablation. In 14 of them, we did CRM after ablation. The following were calculated for each PV: diameter (in morphological sequences and in 4D Flow sequence), flow and flow velocity, by two independent observers. Before and after ablation values were compared. Results: Excellent correlation between the diameter measurements obtained in morphological sequences with the 4D Flow sequence for each PV, intraclass correlation coefficient (95% CI): right superior 0.92 (0.78-0.97), right inferior 0.91 (0.75-0.97), left superior 0.84 (0.56-0.94), and left inferior 0.92 (0.79-0.97). There is an adequate inter- and intraobserver correlation in diameter and flow measurements. A reduction in PV diameter greater than 10% was observed in 21 of 56 veins (37.5%), all of them with mild stenosis. There were no statistically significant variations (p < 0.001) in flow and velocity parameters obtained before and after ablation. Conclusion: The 4D Flow sequence provides morphological and flow information useful in monitoring after PV ablation. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: La ablación de venas pulmonares es un tratamiento eficaz para la fibrilación auricular, aunque puede asociarse a complicaciones como la estenosis de venas pulmonares, cuyo diagnóstico suele basarse en tomografía computada (TC) o cardiorresonancia magnética (CRM). La secuencia 4D Flow en CRM podría aportar información adicional sobre morfología y flujo, antes y después de la ablación, complementando la evaluación habitual. Objetivo: Determinar la utilidad de la CRM con secuencia 4D Flow para la valoración de las venas pulmonares (VP) en el contexto de ablación con radiofrecuencia. Aunque la ablación es una técnica con bajo porcentaje de complicaciones, estas deben diagnosticarse precozmente mediante pruebas de imagen, siendo la TC y la resonancia magnética (RM) las más utilizadas. La secuencia 4D Flow que evalúa flujo intravascular no se ha estudiado en este contexto. Método: 16 pacientes se sometieron a CRM y ablación de VP. En 14 de ellos se completó con una CRM postablación. Se calcularon en cada VP: diámetro (en secuencias morfológicas y en secuencia 4D Flow), flujo y velocidad de flujo, por dos observadores independientes. Se compararon los valores previos y posteriores a la ablación. Resultados: Excelente correlación entre las medidas del diámetro obtenidas en secuencias morfológicas con de la secuencia 4D Flow para cada una de las cuatro VP, coeficiente de correlación intraclase (IC 95%): VP superior derecha 0,92 (0,78-0,97), inferior derecha 0,91 (0,75-0,97), superior izquierda 0,84 (0,56-0,94) e inferior izquierda 0,92 (0,79-0,97). Existe adecuada correlación inter- e intraobservador en las medidas de 4D Flow de diámetro y flujo. Se observa una reducción de calibre de las VP mayor del 10% en 21 de 56 venas (37,5%), todas ellas estenosis leves. No existieron variaciones estadísticamente significativas (p < 0,001) en parámetros de flujo y velocidad obtenidos antes y después de la ablación. Conclusión: La secuencia 4D Flow aporta información morfológica y de flujo útil en el control tras ablación de las VP [ABSTRACT FROM AUTHOR]
Copyright of Revista Argentina de Radiología is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22&#193;lvarez-V&#225;zquez%2C+Ana%22&quot;&gt;&#193;lvarez-V&#225;zquez, Ana&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;&lt;i&gt; anaalvarezvazquez@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22S&#225;nchez-Mart&#237;n%2C+Jos&#233;+T%2E%22&quot;&gt;S&#225;nchez-Mart&#237;n, Jos&#233; T.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Urmeneta-Ulloa%2C+Javier%22&quot;&gt;Urmeneta-Ulloa, Javier&lt;/searchLink&gt;&lt;relatesTo&gt;1,2,3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Andreu-V&#225;zquez%2C+Cristina%22&quot;&gt;Andreu-V&#225;zquez, Cristina&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pizarro-S&#225;nchez%2C+Gonzalo%22&quot;&gt;Pizarro-S&#225;nchez, Gonzalo&lt;/searchLink&gt;&lt;relatesTo&gt;2,5&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mart&#237;nez+de+Vega-Fern&#225;ndez%2C+Vicente%22&quot;&gt;Mart&#237;nez de Vega-Fern&#225;ndez, Vicente&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;
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– Name: Abstract
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  Data: Introduction: Pulmonary vein ablation is an effective treatment for atrial fibrillation, although it may be associated with complications such as pulmonary vein stenosis, which is usually diagnosed with computed tomography (CT) or cardio-magnetic resonance imaging (CMR). The 4D Flow sequence in CMR could provide additional information on morphology and flow, before and after ablation, complementing the usual assessment. Objective: To assess the usefulness of CMR with 4D Flow sequence for the assessment of pulmonary veins (PV) in the context of radiofrequency ablation. Although ablation is a technique with a low percentage of complications, these must be diagnosed early through imaging tests, with CT and magnetic resonance (MRI) being the most used. The 4D Flow sequence that evaluates intravascular flow has not been studied in this context. Method: 16 patients underwent CMR and PV ablation. In 14 of them, we did CRM after ablation. The following were calculated for each PV: diameter (in morphological sequences and in 4D Flow sequence), flow and flow velocity, by two independent observers. Before and after ablation values were compared. Results: Excellent correlation between the diameter measurements obtained in morphological sequences with the 4D Flow sequence for each PV, intraclass correlation coefficient (95% CI): right superior 0.92 (0.78-0.97), right inferior 0.91 (0.75-0.97), left superior 0.84 (0.56-0.94), and left inferior 0.92 (0.79-0.97). There is an adequate inter- and intraobserver correlation in diameter and flow measurements. A reduction in PV diameter greater than 10% was observed in 21 of 56 veins (37.5%), all of them with mild stenosis. There were no statistically significant variations (p &lt; 0.001) in flow and velocity parameters obtained before and after ablation. Conclusion: The 4D Flow sequence provides morphological and flow information useful in monitoring after PV ablation. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducci&#243;n: La ablaci&#243;n de venas pulmonares es un tratamiento eficaz para la fibrilaci&#243;n auricular, aunque puede asociarse a complicaciones como la estenosis de venas pulmonares, cuyo diagn&#243;stico suele basarse en tomograf&#237;a computada (TC) o cardiorresonancia magn&#233;tica (CRM). La secuencia 4D Flow en CRM podr&#237;a aportar informaci&#243;n adicional sobre morfolog&#237;a y flujo, antes y despu&#233;s de la ablaci&#243;n, complementando la evaluaci&#243;n habitual. Objetivo: Determinar la utilidad de la CRM con secuencia 4D Flow para la valoraci&#243;n de las venas pulmonares (VP) en el contexto de ablaci&#243;n con radiofrecuencia. Aunque la ablaci&#243;n es una t&#233;cnica con bajo porcentaje de complicaciones, estas deben diagnosticarse precozmente mediante pruebas de imagen, siendo la TC y la resonancia magn&#233;tica (RM) las m&#225;s utilizadas. La secuencia 4D Flow que eval&#250;a flujo intravascular no se ha estudiado en este contexto. M&#233;todo: 16 pacientes se sometieron a CRM y ablaci&#243;n de VP. En 14 de ellos se complet&#243; con una CRM postablaci&#243;n. Se calcularon en cada VP: di&#225;metro (en secuencias morfol&#243;gicas y en secuencia 4D Flow), flujo y velocidad de flujo, por dos observadores independientes. Se compararon los valores previos y posteriores a la ablaci&#243;n. Resultados: Excelente correlaci&#243;n entre las medidas del di&#225;metro obtenidas en secuencias morfol&#243;gicas con de la secuencia 4D Flow para cada una de las cuatro VP, coeficiente de correlaci&#243;n intraclase (IC 95%): VP superior derecha 0,92 (0,78-0,97), inferior derecha 0,91 (0,75-0,97), superior izquierda 0,84 (0,56-0,94) e inferior izquierda 0,92 (0,79-0,97). Existe adecuada correlaci&#243;n inter- e intraobservador en las medidas de 4D Flow de di&#225;metro y flujo. Se observa una reducci&#243;n de calibre de las VP mayor del 10% en 21 de 56 venas (37,5%), todas ellas estenosis leves. No existieron variaciones estad&#237;sticamente significativas (p &lt; 0,001) en par&#225;metros de flujo y velocidad obtenidos antes y despu&#233;s de la ablaci&#243;n. Conclusi&#243;n: La secuencia 4D Flow aporta informaci&#243;n morfol&#243;gica y de flujo &#250;til en el control tras ablaci&#243;n de las VP [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Revista Argentina de Radiolog&#237;a is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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